Individual
CONEY BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 VERNON RD STE A, LAGRANGE, GA 30240-4143
(706) 880-4143
(706) 880-7343
Mailing address
1600 VERNON RD STE A, LAGRANGE, GA 30240-4143
(706) 880-4143
(706) 880-7343
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
89209
GA
208600000X
Surgery Physician
ME133865
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073600
—
FL
Enumeration date
04/08/2013
Last updated
09/09/2021
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